• N&PD Moderators: Skorpio | thegreenhand

How is amphetamine neurotoxic? What does it do to you?

That has only to do with addicts. Totally irrelevant.

The first part was me paraphrasing a different source.


"Unlike cocaine and amphetamine, methamphetamine is directly toxic to midbrain dopamine neurons."
Ref: Malenka RC, Nestler EJ, Hyman SE (2009). "15". In Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. p. 370. ISBN 978-0-07-148127-4.

Meth is oddly a lot worse for humans than alpha-methyl-amphetamine (phentermine).

I also agree with Ebola about the dose - it's about 2x the therapeutic max for D-amph.
The ranking of the enantiomers by dopaminergic effects is D-meth>D-amph>L-amph>L-meth. Most recreational meth is D-meth for obvious reasons (similarly with amph and D-amph).
 
Methamphetamine is definitely more harmful than amphetamine when taken recreationally, but I'd argue you're smart to hold off on judging amphetamine to be neuroprotective or even 'neuro-healthy'. Wikipedia should be edited to note that the neuroprotective effects of amphetamines are very debatable and dependent on the way the definition is used. Whoever wrote the wikipedia article may have been a bit biased.

To the OP, I'm not a doctor. I have a degree in biochemistry and molecular biology and am in the process of getting an MD/DO (officially no difference in accreditation after this week, hooray!). I have been published and spent three years doing research at a state university, but I'm not the genius in my crowd. In fact, I'm about average for a medical student. This means I have some experience but am far from an expert at this stage in the game. You should contact a professional if you are interested in getting the best opinion. If you want to read my shitty research, PM me lol. Most of my skepticism of academia was borne from watching people pursue research for the purposes of funding, which creates all kinds of problems when you bring big pharma into the picture... another time.


What's the ISBN # of that pharm text?
978-1451113143
It's Lippincott's review, my bad. Our teachers wrote the book, which comes with an ironic true story: several of the contributing professors are horrible lecturers b/c they spend most of their time is spent writing the books. Most of us skipped lecture and read that thing cover to cover... so anyone can do it... and they say you have to go college to get an education. Kudos for having the patience to read biochem papers without someone standing over your shoulder. I never could do that. If you're looking for a great lecture series and have the time, Dr. Najeeb's lectures are a must-watch. You can also drop me an email or even skype it up if it would help you get your hands on some good resources.

So I'm wondering if you know, off hand, which subclasses of adrenergic receptors meth is preferentially selective for in comparison to those amp is selective for (and I'd expect this to vary by stereoisomer too). On the other hand, neither is a strong direct adrenergic agonist, particularly meth, so I wouldn't expect these differences to explain much about how the cardiotoxic effects differ between the two.

ebola
No worries.... I believe meth prefers the alpha-2 receptors. Wikipedia has a pretty good list here. We didn't have time to go over ALL of the subclasses, but you can probably figure out which ones it prefers from your own personal research or anecdotes. stimulation of the adrenergics means you're really pushing your system if you remember what's going on simultaneously in your brain.

http://en.wikipedia.org/wiki/Alpha-2_adrenergic_receptor
^These types of pages are indispensable when looking at drug effects bc we often don't know the mechanism and are trying to figure out what you may experience from new rave drug #123897894. The adrenergics are fascinating, imo, especially when you consider how fast the system 'comes online' when you're in danger.

-Methylated compounds cross the BBB into CNS territory with ease compared to regular amphetamines. I'm gonna geek out and mention you can see why meth is taking over crack town when you look at the drug's proposed MOA. Ties in nicely with what Seppi has been discussing.

I used wikipedia to look up the answer to ebola's question and stumbled into what Seppi was talking about. I noticed some things that may or may not be relevant and have listed them below.

Seppi and ebola

Amp and Meth keep the DAT channel open and inhibits VMAT. Meth apparently binds to VMAT1 and 2 receptors in different regions (of the receptor) and is an agonist of all subclasses of alpha-2 adrenergic receptors. Direct and indirect MOAs don't have much to do with intensity of effects. It's all about the receptor's affinity for a substrate, the function of the receptor, and how fast the drug is cleared from site of action. If you take enough amp, you may be able to plug the VMAT2 receptor via competitive inhibition (assuming there is some affinity for VMAT2) or pimp VMAT1 so hard it inhibits with the same intensity. I'm confident the substrate affinity and binding times of DAT are more important and well understood. With either drug you still run the risk of frying your brain if you push too hard.
^ The VMAT1 and 2 differences are probably the focus of most amphetamine toxicity studies, which is to say the literature is concerned with determining if amphetamine does indeed exhibit a lack of deleterious effects at therapeutic doses in the isolated system. I have often forgetten this when researching drugs, only to walk away with a nugget the author didn't intend to implant. Here's an obligatory metaphor:

Meth = you're giving justin bieber the keys to your ferrarri for three days.
amphetamine = giving a good friend's relative the keys to your ferrari for a test ride... the stranger could be a Belieber, but your risk is mitigated because you know him better.

I always start with a peer-edited review article when studying a new illness bc it frames the research paradigm and gives you all the terminology/acronyms up front. Wiki is an acceptable source for drugs that don't get you high, imo, b/c there's less of an impetus for self-delusion. *Just read you had rewritten the wiki, Seppi. No offense intended but I stand by it.

Later!
 
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Just thought I'd put this out there for shits and giggles.

There is no evidence that Amphetamine is significantly degraded by Monoamine Oxidase. All the studies (I've encountered) point to CYP2D6 as the main enzyme responsible for amphetamine metabolism with some interaction by Flavinoid Monooxygenase (FMO) and Dopamine-beta Monooxygenase (DBH)
 
Sigh. Research has demonstrated amphetamine to be a ready substrate for MAO, and most is excreted unchanged.
...
21 said:
No worries.... I believe meth prefers the alpha-2 receptors.

The relevant comparative data didn't appear on the table linked. However, I looked at the entries in the PDSP database, and indeed, methamphetamine shows affinity for alpha-2b and 2c in the range of the high hundreds of nanomoles, which is pretty weak, but d-amphetamine doesn't bind to these sites at all, so this is likely part of the story behind the experience of meth as 'smoother' at lower dosages and 'tweaky' at higher dosages. However, beta-adrenergic activity has to be another important part of the story, and I don't have the info on that handy.

ebola
 
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Sigh. Research has demonstrated amphetamine to be a ready substrate for MAO, and most is excreted unchanged.

ebola

I said degraded, not metabolized. Amphetamine is a moderate substrate for MAO-B. You need to stop taking my posts at face value.

Research has also demonstrated that Amphetamine is only primarily excreted unchanged in acidic plasma conditions. Low blood pH increases Amphetamines half-life from (around) 12 hours to nearly 24 hours where Amphetamine is then primarily excreted as metabolic byproducts.
 
I said degraded, not metabolized. Amphetamine is a moderate substrate for MAO-B. You need to stop taking my posts at face value.

Research has also demonstrated that Amphetamine is only primarily excreted unchanged in acidic plasma conditions. Low blood pH increases Amphetamines half-life from (around) 12 hours to nearly 24 hours where Amphetamine is then primarily excreted as metabolic byproducts.

Very nice point! Byproducts are the best place to start any conversation on drug metabolism, imo, bc it forces you to rely more on your logicizer than your assimilator. That's what computers are for (right now).

Sigh. Research has demonstrated amphetamine to be a ready substrate for MAO, and most is excreted unchanged.
...


The relevant comparative data didn't appear on the table linked. However, I looked at the entries in the PDSP database, and indeed, methamphetamine shows affinity for alpha-2b and 2c in the range of the high hundreds of nanomoles, which is pretty weak, but d-amphetamine doesn't bind to these sites at all, so this is likely part of the story behind the experience of meth as 'smoother' at lower dosages and 'tweaky' at higher dosages. However, beta-adrenergic activity has to be another important part of the story, and I don't have the info on that handy.

ebola

Yeah, I wish I had the time to dig out some decent stuff for you without violating forum rules. I'm just going to say the words "pirate beach" and mention Dr. Najeeb is from India where piracy laws aren't top priority.

The adrenergics are being flooded with Epi and NE in addition to meth, so you're looking at peripheral vasoconstriction, water retention, pH imbalances, increased contractility and HR, changes in insulin regulation + all the CNS effects,,, quite a bit going on there with just the four main classes of adrenergic receptors.
 
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21 said:
The adrenergics are being flooded with Epi and NE in addition to meth, so you're looking at peripheral vasoconstriction, water retention, pH imbalances, increased contractility and HR, changes in insulin regulation + all the CNS effects,,, quite a bit going on there with just the four main classes of adrenergic receptors.

Right, right. Now, I was never trying to make the case that (meth)amphetamine is not significantly adrenergic (particularly in terms of indirect mechanisms)--it obviously is. This whole time, I've been trying to explore the earlier question of how methamphetamine compares to amphetamine in terms of these effects. We're almost there in terms of relevant data (and I should be able to hunt down those figures on beta agonism given sufficient free time :p). Regardless, I've enjoyed the exchange.


Yeah, I wish I had the time to dig out some decent stuff for you without violating forum rules. I'm just going to say the words "pirate beach" and mention Dr. Najeeb is from India where piracy laws aren't top priority.

We have a stickied thread for the express purpose of distribution of journal articles, and it's always okay to post full citations for others to hunt down on there own. One thing that stands problematic is comparing binding affinities between different substances between studies, as differing methodologies can lead to varying binding affinity data.

Swampy said:
I said degraded, not metabolized.

Okay. How do you think that most things degrade in vivo?

Amphetamine is a moderate substrate for MAO-B. You need to stop taking my posts at face value.

Hah, okay. How should I interpret them instead then?

ebola
 
Okay. How do you think that most things degrade in vivo? Hah, okay. How should I interpret them instead then?

ebola

Alright, degrade, metabolize - whatever, that wasn't the point. My point was; regardless of the fact that Amphetamine is a substrate for MAO, saying so wasn't even necessary for my point. And to reiterate - amphetamine has little to no metabolic degradation mediated by Monoamine Oxidase.

The fact that its a substrate for MAO doesn't even really matter. The fact that you replied to my post, interning that anything that's a substrate for an enzyme, also gets metabolized by that enzyme (and the fact that you don't state these discrepancies all the time) is starting to make me wonder if YOU really understand this information entirely.
 
Hence why I said under 100mg. Talking 40-80mg of 60-70% quality of that dose that is actually (meth)amphetamine. Orally or plugged only. Snorting and Smoking are damaging on their own, no need for help from dirty stims.
 
swampy said:
The fact that its a substrate for MAO doesn't even really matter. The fact that you replied to my post, interning that anything that's a substrate for an enzyme, also gets metabolized by that enzyme (and the fact that you don't state these discrepancies all the time) is starting to make me wonder if YOU really understand this information entirely.

After a cursory lit review, I actually found little evidence suggesting significant metabolism by MAO, running counter to 'common knowledge'. So perhaps, then, amphetamine is merely a very weak competitive inhibitor of MAO. And yes, I didn't understand the information entirely. :p

immunator said:
Hence why I said under 100mg.

"Under 100 mg" doesn't really imply way under 100 mg. If I were to estimate the threshold for neurotoxicity (per what's measurable physiologically, not necessarily what's behaviorally relevant), it might be something like 10 mg.

ebola
 
neurotoxic, means it is toxic for your brain, regulated or not, it is a very strong stimulant, abuse can lead to permanent damage to your dopamine receptors. psychosis is just an "out of realty state", this is what most recreational drug users look for. However, paranoid psychosis is a whole different ballgame and is not fun.
 
psychosis is just an "out of realty state", this is what most recreational drug users look for.

No, psychosis has a far more precise definition, centering on the presentation of delusions and/or hallucinations carrying themes of reference to the psychotic individual.

ebola
 
Well, technically every substrate for an enzyme is also a competitive inhibitor.

ebola
 
Until now, I really haven't been able to identify why meth and amph have different neurotoxic potential. Finally found one reason: meth is a sigma 1/sigma 2 agonist.

http://www.ncbi.nlm.nih.gov/pubmed/21054260
http://www.ncbi.nlm.nih.gov/pubmed/21886562

Apparently it's a property of certain N-methylated phenethylamines (MDMA and methylphenidate are agonists), but I'm looking for a better source than the one I read that in (a primary source on MPH) to cite this.

~20x greater affinity for sigma 1.

Also, meth apparently induces marked acute neurotoxicity. http://www.ncbi.nlm.nih.gov/pubmed/19897075
 
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Until now, I really haven't been able to identify why meth and amph have different neurotoxic potential. Finally found one reason: meth is a sigma 1/sigma 2 agonist.

http://www.ncbi.nlm.nih.gov/pubmed/21054260
http://www.ncbi.nlm.nih.gov/pubmed/21886562

Apparently it's a property of certain N-methylated phenethylamines (MDMA and methylphenidate are agonists), but I'm looking for a better source than the one I read that in (a primary source on MPH) to cite this.

~20x greater affinity for sigma 1.

Also, meth apparently induces marked acute neurotoxicity. http://www.ncbi.nlm.nih.gov/pubmed/19897075


Really weird that the one little methyl would make such a big difference at those receptors. I really don't know as much as I should about the sigma receptors, are sigma agonists generally considered to be neurotoxic?
 
No, they potentiate the toxic effects of methamphetamine through a variety of mechanisms in part because they interact with a ton GPCRs.

Edit: sigma-2 apparently has some activity in triggering cell-death cascades.
 
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Sigma agonists are just plain wierd. Lots of stuff from ibogaine to DXM to cocaine to meth to DMT all interact with sigma receptors. The MAPS article about DMT as an endogenous sigma ligand is a good read.

What a strange set of effects, too. Cough suppression, euphoria, anxiety, hallucinations, convulsions, cholesterol binding and lipid raft control, conditioned place preference, anti-depressant effects... the list goes on.

I think it's also the case that a variety of factors work together to make methamphetamine more toxic than amphetamine, rather than any one property of the drug.
 
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Sigma agonists are just plain wierd. Lots of stuff from ibogaine to DXM to cocaine to meth to DMT all interact with sigma receptors. The MAPS article about DMT as an endogenous sigma ligand is a good read.

What a strange set of effects, too. Cough suppression, euphoria, anxiety, hallucinations, convulsions, cholesterol binding and lipid raft control, conditioned place preference, anti-depressant effects... the list goes on.

I think it's also the case that a variety of factors work together to make methamphetamine more toxic than amphetamine, rather than any one property of the drug.

This all the way around.

Sigma receptors have been incredibly understudied and more research for them really does need to be done. I imagine that they play a big role in psychotic illnesses. But no one can prove that without studying the thing first.

Also, I very much agree. There is likely many factors going on here that makes Methamphetamine more neurotoxic than Amphetamine.
 
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You're wrong, psychosis is a "break from reality"
you don't have to hallucinate or have ideas of reference to be psychotic
it is a spectrum
Diseases like Schizophrenia, schizoaffective, alzheimer's, amphetamine psychosis etc
 
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